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Support healthcare providers with Prior Authorization and Appeals submission to Insurance carrier. + 1-2 years of Pharmacy and/or Medical Claims billing and Coding work experience is preferred.
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Internet requirements include the following:Maintain a secure, high-speed, broadband internet connection (DSL, Cable, or Fiber) at the remote location. Be a champion for each patient and consented care partner(s.
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Deliver virtual or telephonic educational support to identified patients, caregivers, Healthcare Professionals (HCPs) and their staff to meet all relevant standards as set by the client company. Dial-up, satellite, WIFI, Cellular connections are NOT acceptable.
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Answer inbound inquiries of patients, care partners and HCPs. Surge protector with Network Line Protection for CAH issued equipment. 1-2 years of experience with Prior Authorization and Appeal submissions preferred.
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Medical billing certificates a plus, 2-3 years of insurance reimb experience a plus, experience with claim rejection and denials a plus. Understands how to read and interpret explanation of benefits, provides excellent customer service, accounts receivable follow up, obtains insurance authorizations, appeals denied claims.
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Employees are required to work Monday - Friday, 10:00am - 7:00pm CST. Act as primary point of contact for patients and HCPs. We will provide you with the computer, technology and equipment needed to successfully perform your job.
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Your new hire training will take place 8:00am - 5:00pm CST, mandatory attendance is required. Ping Rate Maximum of 30ms (milliseconds) All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, ancestry, age, physical or mental disability, sex, sexual orientation, gender identity/expression, pregnancy, veteran status, marital status, creed, status with regard to public assistance, genetic status or any other status protected by federal, state or local law.
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Responsible for meeting the newly identified patient, patient caregivers, healthcare providers over the phone to provide education on the drug, disease process, diagnostic testing, support services provided by the manufacturer and review benefit information.
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Monitors the work between cross-functional departments by coordinating support to Enrollment, Reconciliation, Premium Billing (ENR), Claims, Grievance and Appeals (GAD) departments. Monitors the work between cross-functional departments by coordinating support to Enrollment, Reconciliation, Premium Billing (ENR), Claims, Grievance and Appeals (GAD) departments.
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It will require a dedicated, quiet, private, distraction free environment with access to high-speed internet. Provide identification, intake, documentation, and submission of all reported Product Complaints, per the manufacturer guidelines.
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Clear understanding and ability to navigate the prior authorization and appeals process with commercial payers. Identification and education regarding billing and coding issues and resolution.
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Submit all adverse event reports to manufacturer/third party vendor within stipulated timeframe; additionally follow up if requested to do so. Understand a patient's support needs and interaction preferences to deliver a seamless, tailored patient experience that helps each patient complete their pathway to treatment as prescribed by their HCP.
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Hardwired to the router. Responsible for the identification, intake, documentation, and submission of all Adverse Event Reports occurring in patients which are taking or have previously taken the manufacturer's product.
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Proactive follow-up with various contacts to ensure patient access to therapy. Sonexus Health reimbursement team, the manufacturer's employees, third party vendors to clearly identify issues and provide resolution.
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Establish an ongoing relationship with each assigned patient, starting with Welcome, onboarding, treatment initiation, continuation, and ongoing interactions. Investigate and resolve patient/healthcare provider inquiries and concerns in a timely manner.
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